The High Court has approved a settlement of €15m in the case of a 10-year-old boy who was brain injured at birth.
It brings to €17.8m the total awarded to Tadgh Costello from Killorglin Co Kerry, one of the highest awards on record.
The money will be held and managed by the High Court on his behalf for what will be complex medical and care needs for the rest of his life.
In emotional testimony to the High Court the boy's mother said "all the millions in the world would not fix" what had happened to her son.
She told the judge the family was happy if the court approved a lump sum award and managed it for their son because they had "reached the limit of endurance" in the long legal proceedings.
She said: "These are not familiar surroundings and for any family that has a disabled child, you want to be at home with them, not here. It affects the whole family."
Tadgh needs 24-hour care, cannot speak and is confined to a wheelchair.
Through his mother, he had sued the Health Service Executive over the circumstances of his birth at Kerry General Hospital on May 25, 2006.
The court heard there was a two-hour delay in delivering the baby in which he suffered brain damage.
It was claimed there was a failure to deliver him on time and to treat it as an emergency case.
Two years ago the HSE apologised to the family after it reached an interim settlement for €2.8m.
On that occasion his mother, Mary, said the apology had come too late.
She said the HSE had fought the case for nine years before accepting liability.
In the witness box today, Ms Costello said her son's health had improved significantly since the interim settlement two years ago because the money is being used for a range of therapies, including physiotherapy.
Approving the settlement today, President of the High Court Mr Justice Peter Kelly paid tribute to the family for the care given to Tadgh.
Mr Justice Kelly also repeated a comment made a year ago that it was "shameful" that the legislation to allow periodic payments in such cases has still not been enacted.
He said his court had seen many families worn down by the legal process who were now opting for lump sum payments instead of repeatedly returning to court for interim payments.
The judge said as a Ward of Court, Tadgh would have the money invested on his behalf by the court in order to pay for his care into the future.
Afterwards, in a statement read by solicitor Susie Elliot the family said the settlement "marks the end of a very long struggle in finally getting justice for our darling boy.
"We are pleased that this legal chapter is now closed and we can now move on with the rest of our lives. The courts are not the place for a family like ours with a disabled child, however we are grateful that the legal system prevailed to see that justice was done.
"When people see the multi-million euro sums in cases like these there can be a misunderstanding that somehow this is a cash windfall for the Plaintiff and the family. That is not so. Given that our son is a Ward of Court, these funds are paid into, held by and managed by the High Court.
"The value of today's settlement reflects the gravity of Tadgh's devastating injuries which are life changing and require 24 hour specialist nursing care and equipment for the rest of his life.
"We would dearly love to give every penny of this back, if somehow he could magically do normal things like walk or talk or play football with his brothers and sisters. Sadly for us this can never be. These are the cards we were dealt and he is the one who pays the ultimate price. That is, the loss of what could have been. Words can't describe that loss, nothing can compensate for that, nothing will fix it, absolutely nothing.
"Tadgh is a very brave and happy child of whom we are extremely proud, as we are of our other children Kate, Pat and Grace."
The statement continued: "We would call on the Government to further investigate the safety records in our hospitals to prevent any more cases like this happening to another child and their family.
"Incidents of medical negligence must never become acceptable statistics in our country. However in the tragic event of one occurring it is imperative that the HSE and the state claims agency together be honest truthful and forthcoming with the family about what happened and why and take steps to make sure those mistakes don't re-occur."
An apology read to the court two years ago said the hospital "would like to apologise unreservedly to both of you and to your son Tadgh for the injuries he sustained at his birth in 2006.
"Sadly, we are unable to change what happened to Tadgh, but we would like to inform you that we have since introduced specific guidelines and protocols to assist us in preventing adverse outcomes in the future."
